In this large retrospective cohort from a single VA center, researchers compared the risk of bleeding after polypectomy in patients on or not on plavix. They found the risk of immediate bleeding was the same, but the risk of delayed bleeding (1-4 days) was higher in the plavix group (3.5% vs 1%), which was much higher in those on concomitant ASA or NSAID (with an odds ratio of bleeding of 3.7 in those on concomitant ASA/NSAIDs versus plavix alone). Given the risk of bleeding is higher with plavix, but the absolute risk of bleeding is low, the decision to discontinue plavix before polypectomy should be made on a case by case basis, but concomitant plavix with ASA/NSAID before polypectomy should be avoided (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.